高血压伴阵发性心房颤动患者发生永久性心房颤动的相关因素

Predictors of progression to permanent atrial fibrillation in hypertensive patients with paroxysmal atrial fibrillation

目的:探讨影响高血压伴阵发性心房颤动(房颤)患者发生永久性房颤的相关因素。方法:随机收集我院高血压伴阵发性房颤患者156例(阵发性组),及高血压伴永久性房颤患者72例(永久性组)。回顾性分析两组患者临床资料,并应用Logistic回归分析高血压伴阵发性房颤患者发生永久性房颤的相关影响因素。结果:与阵发性组比较,永久性组年龄较大[(62±8)岁∶(59±9)岁,P<0.05],心脏彩超测量左房内径[(46.56±5.65)mm∶(42.14±4.47)mm,P<0.05]、左室舒张内径[(51.63±5.63)mm∶(49.35±4.28)mm,P<0.05]和左室收缩内径[(35.05±6.52)mm∶(32.57±4.23)mm,P<0.05]均偏大,左室射血分数[(0.61±0.09)∶(0.64±0.06),P<0.05]、三酰甘油[(1.80±1.22)mmol/L∶(2.21±1.47)mmol/L,P<0.05]较低。Logistic多因素回归分析提示,年龄、左室收缩内径和左房内径是高血压伴阵发性房颤患者发生永久性房颤的相关因素。结论:年龄、左室收缩内径和左房内径是高血压伴阵发性房颤患者发生永久性房颤的重要危险因素。

Objective：To investigate predictors associated with tl^e progression to permanent atrial fibrillation （Af） in hypertensive patients with paroxysmal Af. Method： One hundred and fifty six patients with hypertension and paroxysmal Af （paroxysmal group） and 72 patients with hypertension and permanent Af （permanent group） were randomly collected in our hospital. Retrospective analysis was performed to detect clinical characteristics between two groups. And Logistic regression was also applied to investigate predictors associated with the development from paroxysmal Af to permanent Af in hypertensive patients. Result： Compared with paroxysmal group, the patients in permanent group were older E（62±8） years vs （59±9） years, P〈0. 05], with greater left atrial diameter E（46.56±5.65）ram vs （42. 14±4.47）mm, P〈0. 05], left ventricular diastolic diameter [（51. 63±5.63）mm vs （49.35±4.28）ram, P〈0. 05] and left ventricular systolic diameter [（35.05 ± 6.52）mm vs （32.57±4.23） mm, P〈0.05], but with lower left ventricular ejection fraction [（0.61±0.09） vs （0.64±0.06）, P〈0.05]. Triglyceride [ （1.80 ± 1.22）mmol/L vs （2.21±1.47） mmol/L, P〈0. 05] was lower in permanent group than that in paroxysmal group. Logistic regression analysis indicated that age, left ventricular systolic diameter and left atri al diameter were associated with the development from paroxysmal to permanent Af in patients with hypertension. Conclusion： Age, left ventricular systolic diameter and left atrial diameter are independent predictors in the progression to permanent Af in hypertensive patients with paroxysmal Af.